Fri Feb 10 2023

38 articles - From Friday Feb 03 2023 to Friday Feb 10 2023

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Guidelines

Guidelines and related publications, position statements, white papers, technical reviews, consensus statements, etc…

Pancreatology

Position statement on the definition, incidence, diagnosis and outcome of acute on chronic pancreatitis.

Although the evidence base is poor, this position statement provides a foundation from which to advance management of ACP.

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Meta-analysis

meta-analyses and systematic reviews

Inflamm Bowel Dis

Histological Remission Placebo Rates in Ulcerative Colitis Trials: A Systematic Review and Meta-analysis.

Placebo histological remission rates range from 13% to 19% in UC RCTs, but studies are highly heterogeneous. Factors found to influence placebo rates include presence of background medications, the drug used, and the disease severity. These observations inform future trial designs to minimize placebo rates and reduce heterogeneity.

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Liver Transpl

De novo metabolic syndrome after liver transplantation: a meta-analysis on cumulative incidence, risk factors, and outcomes.

De novo PTMS is a common complication and is significantly associated with increased cardiovascular disease morbidity. High-risk patients such as elderly recipients, those with pre-LT type II diabetes mellitus, or NASH-related cirrhosis should undergo routine screening to allow timely intervention.

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Hepatic steatosis after liver transplantation: a systematic review and meta-analysis.

Diabetes mellitus and post-LT metabolic syndrome are the strongest risk factors for HS and baseline NAFLD for steatohepatitis. All transplanted patients should be enrolled in lifestyle interventions to prevent post-LT metabolic syndrome, and sirolimus should be avoided in high-risk patients.

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Original articles

RCT, clinical trials, retrospective studies, etc…

Inflamm Bowel Dis

Hepcidin and Iron Status in Patients With Inflammatory Bowel Disease Undergoing Induction Therapy With Vedolizumab or Infliximab.

Hepcidin levels in IBD are primarily determined by ID, even in an inflammatory state. In addition, induction therapy can decrease hepcidin levels, which might lead to better bioavailability of iron supplements. Therefore, hepcidin is a potential diagnostic ID biomarker that could assist therapeutic decision making.

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Induction and Maintenance Treatment With Upadacitinib Improves Health-Related Quality of Life in Patients With Moderately to Severely Active Ulcerative Colitis: Phase 3 Study Results.

Induction treatment with UPA 45 mg significantly improved HRQoL measures. A significantly higher percentage of patients who responded to induction treatment with UPA maintained clinically meaningful improvements consistently across a wide range of HRQoL outcomes after 52 weeks of maintenance therapy with UPA (15 mg and 30 mg) compared with placebo. (ClinicalTrials.gov, Numbers NCT02819635, NCT03653026).

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Microbial Dynamics in Newly Diagnosed and Treatment Naïve IBD Patients in the Mediterranean.

Untreated and newly diagnosed IBD shows clear differences from healthy microbial communities and an elevated level of disturbance, but only the network perspective revealed differences between pathologies. Furthermore, future IBD treatment is to some extent predictable by microbial community characteristics.

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Myeloid FTH1 Deficiency Protects Mice From Colitis and Colitis-associated Colorectal Cancer via Reducing DMT1-Imported Iron and STAT3 Activation.

Our study demonstrated that myeloid FTH1 is required for colitis and colitis-associated colorectal cancer via maintaining of DMT1-iron-STAT3 signaling activation under excess iron condition.

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J Crohns Colitis

Clinical and MRI evolution after local injection of bone marrow-derived mesenchymal stem cells in perianal fistulae in Crohn's disease: results from a prospective monocentric study.

Open-label injection of bone marrow-derived mesenchymal stem cells was safe and was effective in half of the patients in fistulizing perianal CD and induced significant MRI changes associated with favorable clinical outcome.

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Declining enrolment and other challenges in IBD clinical trials: Causes and potential solutions.

This joint effort is proposed as the basis for profound clinical trial transformation triggered by investigative centers, contract research organizations (CROs), sponsors, and regulatory agencies.

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Filgotinib Improved Health-Related Quality of Life and Led to Comprehensive Disease Control in Individuals with Ulcerative Colitis: Data from SELECTION.

Filgotinib 200 mg results in short- and long-term improvements in HRQoL. High level improvement of HRQoL relates to a stringent composite endpoint suggesting meaningful disease control in a subset of filgotinib-treated individuals.

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Multi-item Measures for Pediatric Inflammatory Bowel Diseases: The ABCs of All Those Acronyms.

Despite these advances, quantifiable pediatric IBD-specific tools are still lacking for disability and fatigue. In this review, we provide a contemporary, clinically-focused overview of the indices that a pediatric gastroenterologist can use to quantify disease status.

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Prospective validation of the Lémann Index in children: a report from the multicenter ImageKids study.

Overall, the updated LI had insufficient psychometric performance for recommending its use in children. An age-specific index may be needed for children with shorter disease duration than typical adult cohorts.

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Liver Transpl

Center use of technical variant grafts varies widely and impacts pediatric liver transplant waitlist and recipient outcomes in the United States.

S. Policy and training to increase TVG usage, availability and expertise is critical.

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Combined heart liver transplantation practices survey in north america: evaluation and organ listing practices.

In our survey of North American centers that had performed at least 1 CHLT in the past 5 years, we observed heterogeneity in practices for both evaluation and listing protocols in these patients.

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Costs of pediatric liver transplantation among commercially- and medicaid-insured patients with cholestasis in the United States.

Overall, pediatric LT resulted in substantial HRU and cost burden in both commercially- and Medicaid-insured patients. Novel targeted medications able to negate the need for pediatric LT could decrease the associated morbidity and costs.

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CT-quantified sarcopenic visceral obesity is associated with poor transplant waitlist mortality in patients with cirrhosis.

SVO was associated with increase waitlist mortality in patients with cirrhosis in the ambulatory setting awaiting liver transplantation. Concurrent loss of skeletal muscle and gain of adipose tissue seen in SVO quantified by CT may be a useful and objective measurement to identify patients at risk for suboptimal pretransplant outcomes.

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Drug-eluting stent use with abbreviated dual-antiplatelet therapy post percutaneous coronary intervention for liver transplantation evaluation.

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Effects of 20% albumin infusion therapy during liver transplantation on plasma neutrophil gelatinase-associated lipocalin level: a randomized controlled trial.

In conclusion, intraoperative infusion of 20% albumin 200 mL increased albumin level but failed to maintain serum albumin=3.0 mg/dL during surgery. The hypertonic albumin therapy did not significantly affect plasma NGAL level and clinical outcomes including AKI.

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Evaluation and management of the living donor recipient.

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Evolution of pretransplant cardiac risk factor burden and major adverse cardiovascular events in liver transplant recipients over time.

The lack of change in MACE despite an increase in CV risk factor prevalence may reflect advancement in the identification and management of CV risk factors in LTRs. With projected continued increase in cardiac risk burden and the proportion of patients transplanted for NASH, it is critical for LT programs to develop and implement quality improvement efforts to optimize CV care in LTRs.

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Feasibility, safety, and outcome of second-line nivolumab/bevacizumab in liver transplant patients with recurrent hepatocellular carcinoma.

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High-resolution mr imaging with gadoxetate disodium for the comprehensive evaluation of potential living liver donors.

Our one-stop comprehensive liver donor MR imaging protocol can provide complete information regarding hepatic vascular and biliary anatomies, hepatic parenchymal quality, and liver volume for living liver donor candidates and can replace composite multi-modality evaluation.

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Impact of different ischemia times on biliary stricture after living donor liver transplantation with biliary atresia.

AIT was the only independent risk factor for the development of BS after LDLT with BA, and AIT =40 min would increase the 5-year cumulative risk of BS in our study. A shorter AIT, especially AIT <40 min, should be kept to decrease BS.

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Incidence and outcomes of liver retransplantation using living donor allografts in the United States.

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Infections in liver transplant recipients.

Pre-LT testing is often unreliable in patients with cirrhosis so a high index of suspicion must be maintained in those from endemic areas. In conclusion, DDIs and OIs are common and are associated with morbidity and mortality if not appropriately diagnosed and treated.

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Liver Transplantation in Alcohol-Related Liver Disease: Ensuring Equity Through New Processes.

As we look towards the future, we must emphasize the use of evidenced-based measures in selecting patients for listing, ensure access to high quality addiction care for al patients pre- and post-transplant, and adopt harm reduction beliefs to better address relapse when it inevitably occurs. We believe that only by addressing each of these issues will we be able to ensure more equitable distribution of resources in liver transplantation for al patients.

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Neoadjuvant programmed cell death 1 inhibitor prior to liver transplantation for hepatocellular carcinoma is not associated with increased graft loss.

In conclusion, PD1 inhibitor is a safe and feasible method for bridging or downstaging treatment before liver transplantation. Although preoperative PD1 inhibitor may increase the incidence of postoperative rejection, it is not associated with increased immune-related graft loss and patient death.

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Patient reflections, challenges, and supports related to early liver transplant for severe alcohol-associated liver disease.

ELT recipient experiences reveal complex psychosocial challenges related to addiction, inadequate support system, and stigma, particularly in the posttransplant period. The care of ELT recipients would be incomplete if focused solely on optimizing patient or graft survival.

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Patients are pragmatic and physicians are perfectionists? Comparing success after liver transplantation among patients and physicians.

Complications are perceived differently by patients and physicians. Awareness of this discordance may serve to enhance relationships between transplant patients and their providers.

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Postoperative fibrinolytic resistance is associated with early allograft dysfunction in liver transplantation: A prospective observational study.

In conclusion, FR on POD-1 is associated with EAD and decreased graft survival time. Postoperative viscoelastic testing may provide clinical utility in identifying patients at risk for developing EAD, especially for recipients receiving DCDD grafts.

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Risk factors for antibody-mediated rejection in ABO blood-type incompatible & donor-specific antibody-positive liver transplantation.

In conclusion, preoperative MELD =13 and pre-rituximab anti-ABO IgM-titer =128 for ABOi-LDLT, and the combination of sum-MFI =10,000 and multi-loci pDSAs for pDSA-LT, are risk factors for AMR in the era of rituximab desensitization. Characteristically, ABOi-AMR significantly deteriorated graft and recipient survival, whereas pDSA-AMR did not.

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The trends in cost associated with liver transplantation in the US: analysis of weighted hospital data.

The number of liver transplants performed in the US, as well as the associated costs, are rising. Given the apparent rising costs in specific patient populations, economic and public health policies must focus on cost containment within these groups to ensure appropriate usage of resources.

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Reviews&Editorials

Plenty of the editorials are available as full text through the publisher website using the provided link


Miscellaneous

misc publications eg case reports, tools of the trade, images of the month, etc…

Inflamm Bowel Dis

Treatment of Chronic Inflammatory Pouch Conditions With Tofacitinib: A Case Series From 2 Tertiary IBD Centers in the United States.

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Liver Transpl

Compartmentalizing risk with sarcopenic obesity.

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Minimally invasive living donor liver transplantation: the future is here.

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More than a few good women: honoring the ladies of the liver.

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Protective effect of low-dose aspirin against acute cellular allograft rejection after primary liver transplantation.

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Letters&Replies

Letters to the editors and authors’ replies